School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon.
BMC Psychiatry. 2024 Jan 10;24(1):42. doi: 10.1186/s12888-023-05490-5.
Reflecting on the existing literature on suicidal ideation and Avoidant/Restrictive Food Intake Disorder (ARFID), this article investigates the complex relationship between them, hypothesizing about the possibility of dysmorphic concerns, being a mediator linking ARFID to suicidal ideation.
Using a snowball sampling approach, a survey was created on Google Forms and circulated across messaging applications and social media networks (WhatsApp, Instagram, Messenger). The sample involved 515 participants recruited between February and March 2023. The questionnaire included the following scales: Nine-items Avoidant/Restrictive Food Intake Disorder screen (NIAS), Dysmorphic Concern Questionnaire (DCQ), and Columbia-Suicide Severity Rating Scale (C-SSRS). When filling the questionnaire, respondents were warned that they can experience distress when answering certain questions and received information about mental health services. Five hundred fifteen adults participated in this study, with a mean age of 27.55 ± 10.92 years and 60.1% females.
After adjusting over potential confounders (i.e., age, education, marital status, and household crowding index), analyses showed that dysmorphic concerns fully mediated the association between avoidant restrictive eating and suicidal ideation. Higher avoidant restrictive eating was significantly associated with more dysmorphic concerns, and higher dysmorphic concerns were significantly associated with the presence of suicidal ideation. Finally, avoidant restrictive eating was not significantly associated with suicidal ideation.
This study highlights the potential indirect link between ARFID and suicidal ideation mediated by dysmorphic concerns. While no direct connection was observed between ARFID and suicidal ideation, the presence of dysmorphic concerns appeared to be a crucial factor in amplifying the risk of suicidal ideation in individuals with ARFID. This emphasizes the importance of addressing dysmorphic concerns alongside ARFID treatment to enhance mental health interventions and outcomes.
本文回顾了关于自杀意念和回避/限制型食物摄入障碍（ARFID）的现有文献，探讨了二者之间的复杂关系，提出了一个假说，即认为可能存在躯体变形障碍，这种障碍可能是将 ARFID 与自杀意念联系起来的中介因素。
本研究采用滚雪球抽样法，在 Google 表单上创建了一份调查，并通过消息应用程序和社交媒体网络（WhatsApp、Instagram、Messenger）进行了传播。该研究于 2023 年 2 月至 3 月期间招募了 515 名参与者。问卷包括以下量表：九项回避/限制型食物摄入障碍筛查量表（NIAS）、躯体变形障碍问卷（DCQ）和哥伦比亚自杀严重程度评定量表（C-SSRS）。在填写问卷时，研究人员提醒受访者在回答某些问题时可能会感到痛苦，并向他们提供了有关心理健康服务的信息。共有 515 名成年人参与了这项研究，平均年龄为 27.55±10.92 岁，女性占 60.1%。
在调整了潜在混杂因素（即年龄、教育程度、婚姻状况和家庭拥挤指数）后，分析结果表明，躯体变形障碍完全中介了回避限制型进食与自杀意念之间的关联。回避限制型进食与躯体变形障碍显著相关，而躯体变形障碍与自杀意念显著相关。最后，回避限制型进食与自杀意念之间无显著相关性。
本研究强调了 ARFID 和自杀意念之间可能存在由躯体变形障碍介导的间接联系。虽然 ARFID 与自杀意念之间没有直接联系，但躯体变形障碍的存在似乎是 ARFID 个体自杀意念风险增加的一个关键因素。这强调了在 ARFID 治疗中同时解决躯体变形障碍的重要性，以增强心理健康干预措施和结果。
